Document LK82xdVnzQpNgmGO3zJ7n1y6b

March 30 , 1938 Dr . William P. Ger aghty 2225 St . Paul St r e e t Ba lt im o r e , Maryland Dear Doctor Ger agh ty A sh or t time ac;o I saw your r ep or t of a case o f lead encephalopathy from the t h e r a p e u t ic use of lead and opium p i lls as pr esented in the Jou r n a l of the American Me d ica l,As s o ci t io n . I t occur s to me th at you m ight have obtain ed r e p r in t s of a r e p o r t as in t e r e s t in g as t h is , and i f you have such r e p r in t s a v a ila b le I would ver y much a p p r e cia t e havin g one o f them# .. The ch ie f purpose of my note is to make the above r e q u e s t . However ther e is one p oin t in the r e p o r t which seems to ju s t ify a connaent, and I am takin g the lib e r t y o f making such a comment. The r e p o r t would appear to in d ica t e t h a t the dosage o f le ad in t h is in st a n ce was q u it e s m a ll. I was somewhat s u r p r is e d , t h e r e fo r e , to fin d th at t h is was r e a lly not the case fo r when one figu r e s the le ad in t a ke In terms of our p r esen t p oin t o f view w ith r e s p e ct t o the th r esh old dosage fo r in t o x ic a t io n , t h is dose seems t o me to be ver y la r g e . I dp not con sid er i t s u r p r is in g t h a t the p a t ie n t was s e r io u s ly poisoned and I am disp osed to b e lie ve t h a t an e n t ir e ly normal h e a lt h y person would have been poisoned by such a d osage. Perhaps t h is would not have occur r ed so soon alth ough I t h in k s ign s of in t o xica t io n would pr obably have occur r ed In most in d iv id u a ls . Pr obably the in t o xi ca t io n would n bt have been so se r iou s in the case o f a h e a lt h y in d iv id u a l, but even t h is Is co n je ct u r a l* I am p a r t icu la r ly In t e r e s t e d in the r e s u lt s in ce a t the p r esen t time we ar e ca r r yin g out some exper im en tal ob ser vation s on h e a lt h y persons who are r e ce ivin g known sm all doses of lead by mouth. *Ve ar e s t a yin g w e ll w ith in what we con sid er a s a fe dose and we ar e stu d yin g the complete in t a ke and output o f le a d . Con se q u en tly I am in t e r e s t e d in any and a l l case r ep or ts in which known q u a n t it ie s of lead have been added to the normal lead in take over any con sid er able period of time* The a n a ly t ica l r s u lt a in t h is in s t a n ce are qu ir e in t e r e s t in g , and I t is n ot a t a ll s u r p r is in g t h a t a p a t ie n t 2. with the con cen tr ation of lead reported as having been found in the blood and u r in e , should have developed prominent ce n t r a l nervous system symptoms* I consider i t ver y fo r t u n a t e t h a t these symptoms subsided and t h a t the p a t ie n t had no apparent permanent s e q u e lla e . In any case I am ver y gla d t h a t you took the tr ou b le t o p u b lish t h is case r e p o r t . Very t r u ly you r s, RAKji s Ro b e rt A* Keh'ce ,'r iC d .